POC HIV Testing and Early DTG Use for Infants

NCT ID: NCT05393193

Last Updated: 2024-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

900 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-04

Study Completion Date

2026-08-31

Brief Summary

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This study is being conducted to explore the feasibility of implementing targeted birth HIV testing of high-risk neonates using facility-based point-of-care (POC) HIV diagnostics, and to improve the ability to implement the best standard-of-care treatment possible. Infants found to be HIV infected will be immediately offered enrollment into a dolutegravir (DTG) antiretroviral treatment study cohort (if maternal consent is granted) or referred for treatment at a government facility. Infants who enter the study treatment cohort will be prospectively followed through 96 weeks of age. ART will follow Botswana guidelines.

Detailed Description

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Conditions

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HIV

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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HIV-exposed neonates

Point-of-care HIV testing at birth

Group Type OTHER

Point-of-Care Cepheid Xpert HIV-1

Intervention Type DIAGNOSTIC_TEST

Post-partum HIV-positive women with pre-determined risk factors for vertical HIV transmission will be offered point-of-care HIV testing for their newborns for early infant HIV diagnosis.

HIV-positive infants identified through birth HIV screening

Early antiretroviral treatment per standard of care, including dolutegravir-based regimen beginning at 4 weeks of age for infants weighing at least 3.0kg.

Group Type OTHER

DTG/ABC/3TC

Intervention Type DRUG

Infants will be started on a combination of NVP/ZDV/3TC. A switch to DTG/ABC/3TC will occur for all infants at or after 4 weeks (28 days) post-delivery for those weighing ≥3kg. Dosing of all ART will be weight-based by the Botswana treatment guidelines.

Interventions

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Point-of-Care Cepheid Xpert HIV-1

Post-partum HIV-positive women with pre-determined risk factors for vertical HIV transmission will be offered point-of-care HIV testing for their newborns for early infant HIV diagnosis.

Intervention Type DIAGNOSTIC_TEST

DTG/ABC/3TC

Infants will be started on a combination of NVP/ZDV/3TC. A switch to DTG/ABC/3TC will occur for all infants at or after 4 weeks (28 days) post-delivery for those weighing ≥3kg. Dosing of all ART will be weight-based by the Botswana treatment guidelines.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Mother 18 years of age or older
2. Mother willing and able to provide verbal consent for infant testing
3. Infant birth weight ≥1.5kg
4. Presence of any of the following risk factors:

\<12 weeks of ART prior to delivery (including no ART); Known HIV-1 viremia (above level of detection) for last test performed or at any time \>24 weeks gestation in pregnancy; CD4 cell count known to be \<350 cells/mm3 within the past year; Self-described poor adherence in pregnancy (1 or more complete days of missed ART)


1. Mother 18 years of age or older
2. Mother willing and able to provide written informed consent for study participation for herself and her infant
3. Positive point-of-care HIV screening for infant (HIV DNA PCR pending or completed)
4. Infant eligible for ART treatment in accordance with the Botswana government program
5. Infant birth weight ≥1.5 kg

Exclusion Criteria

1\) Medical condition making it unlikely that the infant will survive to 24 months


1. Medical condition making it unlikely that the infant will survive to 24 months
2. Infant unable to start treatment-dose ART \< 168 hours of age
3. Infant unable to attend follow-up visits at a BHP study clinic in Gaborone or Francistown
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Botswana Harvard AIDS Institute Partnership

OTHER

Sponsor Role collaborator

Ragon Institute of MGH, MIT and Harvard

OTHER

Sponsor Role collaborator

Botswana Ministry of Health

OTHER_GOV

Sponsor Role collaborator

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Harvard School of Public Health (HSPH)

OTHER

Sponsor Role lead

Responsible Party

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Roger Shapiro

Associate Professor of Immunology and Infectious Diseases

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Roger L Shapiro, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Harvard School of Public Health (HSPH)

Locations

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Botswana Harvard HIV/AIDS Institute Partnership

Gaborone, , Botswana

Site Status

Countries

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Botswana

Other Identifiers

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P01HD107670

Identifier Type: NIH

Identifier Source: secondary_id

View Link

155BHP

Identifier Type: -

Identifier Source: org_study_id